Archives for June 2012

Time In ICU

I know I promised a post about my stay in the ICU a while back, but to be perfectly honest–I don’t remember much about those days. It wasn’t until I received a copy of my medical records from the hospital yesterday that I found out what happened during that time.

If you have never heard of ICU Psychosis, Let just tell you a little bit about it.  ICU psychosis is a condition that causes patients in an intensive care unit (ICU) or a similar setting to experience serious psychiatric symptoms.  ICU psychosis is also a form of delirium, or acute brain failure.

There are a number of reasons why ICU patients develop ICU Psychosis: Sensory Deprivation, Sleep Deprivation, Stress, and Medical Monitoring, are listed among environmental causes. Medical causes add to the list with pain, critical illness, medication reactions and side effects, infection, and dehydration. All of these things added together can cause a patient in ICU to develop serious psychosis responses.

So, you ask, what are the symptoms of ICU Psychosis? They include extreme excitement, anxiety, restlessness, hearing voices, hallucinations, nightmares, paranoia, disorientation, agitation, delusions, and abnormal behaviour.

Although I don’t recall much from my time in ICU, I do remember quite well some of the ridiculous things I did and experienced while there. I can not begin to imagine how much distress and worry I caused my family because of this.

My daughter, Becca, lives in Calgary, Alberta, Canada. I called her in the middle of the night ten times in a row, begging her to come and get me out of the hospital. I was convinced that her dog, Ilex, was sitting right outside the door to my room in ICU, so I was calling her to come and sit with me. Of course, in reality, neither Becca or Ilex were there.

I dreamed that I got a letter from a woman who told me that my husband was her boyfriend. I was so convinced that I got that letter that I was calling my children and step-daughter to tell them about it. I never took into consideration that Fabgrandpa and I live in a 32 foot RV trailer, and spend twenty four hours a day, seven days a week together, so there was no way at all that this could be true. And of course, that “letter” that I supposedly received was never found in the gigantic stack of mail that I did receive.

One of my best friends in the world works as a special agent for Department of Homeland Security. I called her one night, telling her that the hospital staff in ICU was trying to kill me, and that she needed to come to Flagstaff (from Florida) to arrest them all and take them to jail. I was thoroughly convinced that the nurses and doctors on staff were taking bets on what time I would die. Exceptionally crazy? Yes, I think so now, but at the time, I was convinced.I also thought she actually came to the hospital, and I could hear her talking out in the hallway. And of course, she wasn’t there.

I called all my friends and family, begging them to come and get me out of the hospital. Several times. Thinking back on it now, I think they never should have allowed me to have my cellphone with me in ICU, and If I ever wind up there again, they should take my phone until I am over the worst of things.

On the first day that I was out of ICU, I was determined to leave the hospital. I was wearing only a hospital gown and a colostomy bag, had no clothes, no truck, no money, but I was determined to leave. I tried to get up out of the bed, and only succeeded in messing up my colostomy bag and had to have the bed changed and be cleaned up by the nurses on duty.

On the second day, I pulled the NG tube out of my nose. When I did that, I immediately started throwing up all over my bed and myself. Again, the nurses and patient care techs had to change my bed and clean my up. After that ordeal, I got very hot, so I took off my hospital gown and laid in bed naked. IN the morning, a nurse came in and told me that I was being monitored via a camera in the ceiling. She said that they had observed me laying there with no clothes on all night, and she wanted me to know.

After that, I tried my best to behave and cooperate with the doctors and nurses, so I could get better enough to come home.

 

Your Reputation

How many times have you heard that your reputation is you? Your reputation is one of the most valuable assests you can have. When you are dependable, honest, and keep your promises, your reputation can be impeccable. When you are less than honest, and don’t carry through when you give your word, your reputation becomes tarnished.

Just as your actions in real life can boost or degrade your reputation, things that are being said about you online, whether true or not, can also affect your reputation. Anyone can go online and write anything they want to about you, and often times you won’t even know about it. Maybe someone with a name the same as or similar to yours is a not so honest person. They may write untrue or shady information, and it can be attributed to you because the name is the same.

A new website, Reputation.com, can help you find what is being written or said about you on the internet. When you sign up, you input your profile information, then search for items about you on the internet. Once items are found that the program thinks is you, you can choose an option called “not me” to remove items that are not about you. This looks like a good way to clean up and monitor your reputation online.

One Nurse Who Made A Difference

During my hospital stay that lasted from May 10th thru June 12th, 34 days, I had many many nurses who took care of me. When I came out of ICU into a regular room on the 3rd floor, I was experiencing some depression and anxiety. I was also still on morphine, and was not thinking straight because of it.Of all the nurses and patient care technicians I met, one stood out as exceptional in my mind.

Her name was Karen, same as my name. She took extra time to just talk to me, to soothe my anxiety, to just be a person and not just a nurse. In my drugged state, I know I asked some weird questions, and said some nonsense things, but Karen never laughed or dismissed me. She truly tried to help me in a personal way.

On one particular day, I misread or misunderstood something that was written on my daily agenda. I thought that because I had failed to complete a certain number of exercises on that day, that I had no hope of recovering from my surgery. Isn’t is funny how we can misinterpret things when we are on drugs? Anyway, I was trying to explain to Karen what I was talking about, and trying to ask her if there was anything else I could do to “catch up” or disregard the outcome of the lack of meeting the goal.

Karen took the time to explain that my “failure” was not really a failure to anyone but me in my mind, that the goals written by the doctor were not absolute, just what they would like for me to be able to do by the end of the day. Not reaching the goal did not doom me to being in the hospital forever.

Because she was so friendly, so caring, so human, I want to do something, like maybe send a Interflora gifts for her.  I know I felt like I didn’t thank my healthcare providers enough throughout my stay at the hospital, and feel like sending a special thank you to someone who made me feel sane would be in order.

 

Why Can’t I Just Make A Reservation???

We have had to go back to Flagstaff twice now for follow-up appointments with the surgeon. And we have to go back again next week.  I love Flagstaff, but making that 400 mile roundtrip every week is getting old, especially since I am recovering from major extensive surgery.

The first week we went back down to Flag, we stayed at the Travel Lodge at 1560 E. Route 66. I have a walker and a shower chair that I have to use, but didn’t think about needing special accommodations for the bathroom. We were able to squeeze the shower chair in the bathtub, but since there were no grab bars, I had to have Fabgrandpa or my daughter help me get in and out of the tub. I am still having a hard time lifting my feet up very high, so this was a challenge.

This week, instead of making the reservation online, I called the Travel Lodge and asked if they had any handicap accessible rooms. They said they did, so I made my reservation for one. However, when we arrived, the person at the desk said that whoever took my reservation did not make a note that I had requested a handicap room, and they had already given that room to someone else. I was livid!

The clerk went on to say that the only difference in the handicap accessible room was that there were grab bars in the bathroom and a dedicated parking space in front of the room. Well, DUH! That was exactly what I was looking for. We stayed there in the same room we were in last week, and Fabgrandpa had to help me in and out of the shower.

When we got home, I called Fairfield by Marriot, a hotel we have stayed in before, and talked to them to make a reservation. I told them we had three adults staying in the room, and that I needed a room with a handicap accessible bathroom. I also asked for their “medical rate” because a lot of hotels will give you a discount if the purpose of your visit is for a medical appointment. The girl assured me that they could accommodate my needs, and quoted a discounted rate of $132.64 (that included taxes.)

Today, I opened my confirmation email from them, and discovered that they had booked me a room with one king bed. For three adults. I called them to check on that, and was told that in order to get a handicap accessible room, I could only get 1 king bed. I told them that was not acceptable, and asked why they didn’t tell me that at the time I made the reservation.  She was very polite, and explained their room accommodations, and gave the name of another hotel across the street that would be able to provide a room with two double beds AND handicap accessible bathroom.

I called Springhill Suites by Marriot. They were able to reserve a room with two queen beds, and handicap accessible bathrooms, at a rate of $92.78 (including taxes.) My confirmation email seems to be correct. We’ll see what we get when we check in next week.

But I have to ask:  How can a motel get away with not honoring your request for an accessible room? Why can’t they just tell you the truth when you call to make a reservation? I would rather continue looking for a room to fit my needs than make a reservation and be disappointed when I arrived.

 

More About The Surgery

These are just some things that happened during the first part of my stay at Flagstaff Medical Center, before I had surgery and was moved to ICU.  In the days leading up to the surgery, I was given gastrografin enemas very day. At one point, one of the doctors told me that if I could have a bowel movement I could go home the next day. That afternoon, I did have a very small movement so I called my friend, Gaelyn, and asked her to come and get me. Of course we all know that didn’t happen.

A couple of times, the nurse also filled my stomach with gastrografin by using a syringe and inserting the liquid through the NG tube. After I was filled up on both ends I was taken for a CT scan. That was not fun at all.

I was on a clear liquid diet, supplemented by TPN through the PICC line. I was on morphine, and was very weak. The doctors and nurses all told me every chance they got that my condition would improve if I would get up and walk. I really tried to get up, but even before surgery, it was very difficult for me to do. One day, one of the nurses on the floor told me to walk over to the “Sky Bridge”, which is a part of the hospital that goes over the road. There is a very nice view to the north of the San Fransisco Peaks and to the south of downtown Flagstaff. Because I was really wanting to cooperate with the medical team that was in charge of my care I agreed to take the walk.

This nurse walked me over there, and left me there sitting on the wall. She went back to the floor, quite a distance away. I had no walker, no cane, no wheelchair. I was sitting there by myself, and started throwing up. I couldn’t stop, and there was no one around to ask for help. I felt so helpless. After a few minutes, a hospital worker came by, and ran to the closest nurses station for help. I was so upset that my nurse would leave me completely helpless like that.

On the first or second day there, Fabgrandpa was trying to get some cash out of the ATM. We had changed banks before we left Georgia, and when our ATM card pins came in the mail, they didn’t work. We had to call the new bank and request new pin #’s. We had used the same pin code on our ATM cards for 12 years, so when the new ones came, we had a hard time remembering the codes.

Fabgrandpa went to the gas station and filled up the truck. Then his ATM card wouldn’t work because he couldn’t remember the pin code. I had also given him my Paypal debit card, which is a cash card, not a credit card. The pin code for it was the one we have used for 12 years. But, his purchase was declined! He called me at the hospital very upset, wanting to know what to do next. At the same time I was on the phone with him, I was getting a beep that I had another call. It was Paypal, wanting to verify that the purchase at the gas station was not a fraudulent purchase, because I got the card in Georgia and had never used it, and the first purchase was in Arizona. I confirmed that it was not a fraudulent purchase, and they approved the charge. I really do understand when banks do this, but sometimes it is a pain in the rear.

Surgery

When we first got to Flagstaff Medical Center, I was told that I would not need surgery. The doctors said they could treat the infection, then do a colonoscopy prep to clean me out, and get rid of the obstruction in my bowel. Things didn’t happen quite that way.

The doctors waited 13 days for the infection to clear up. Most of what I am going to write today I learned from reading my daughters’ Facebook timelines, where they were keeping friends and family updated on my condition.

As I wrote yesterday, I was pretty much zinged out on morphine, and had an NG tube and a PICC line in my arm for IV feeding of TNP. There was also a PICC line in my groin, I’m not sure what that one was for.

On May 23, I started throwing up fecal matter. There is no pleasant way to say that. It was the most horrible thing, ever, even after all I have been through. Once I started that, the doctor decided to do a sigmoidoscopy. The doctor who did the sigmoidoscopy said that she couldn’t get the instrument past the small bowel. There was an obstruction there that prevented going any further. That is when they decided surgery was necessary. (again, I could be wrong about some of this because I do not even remember the sigmoid procedure. I was out cold!)

I was scheduled to go into the OR around 1:00 p.m. MST, but didn’t make it there until around 4:00 p.m. (I think). I am not sure what that surgery entailed. The updates on Facebook called it a “cleanout procedure”. Fabgrandpa told me they opened me up, cleaned out fecal matter and infection, cleaned my insides up, and covered it with a surgical sponge. The surgical incision was left open, and I was taken back to surgery at least two more times to change the sponge and cleanout infectious tissue.  At some point during all this surgery, the small bowel obstruction was removed and I received a colostomy.

Tomorrow, the ICU.